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Social Determinants of Health

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Subject:
From:
Robert C Bowman <[log in to unmask]>
Reply To:
Social Determinants of Health <[log in to unmask]>
Date:
Thu, 21 Sep 2006 10:30:32 -0500
Content-Type:
text/plain
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Pop Pop Pop

Loud, echoing, and much too close.

Call 911. Shots fired. Right behind us. This was not a movie, it was
reality.

My 13 year old son was excited. I was afraid, for him and for me. We turned
around and searched for answers. No one else was diving for cover. This
seemed odd.

Where were the shots coming from? Was anyone shot?

The people in the parking lot were looking down the street. No one seemed
hurt or overly excited.

Are we safe? Are they gone? Who was it? What were they doing?

The pieces begin to come together. Just after we entered the parking lot,
shots were fired from a car departing the same parking lot.

Why would anyone empty a gun in the city, in the public, around children,
around my child?

Fortunately other children were inside and did not hear. They did not
experience the fear or the excitement. This time.

More time and more conversation. The first police car. A second sets up a
wary patrol up and down the street.

This time there is a good description of the car leaving the scene. They
wandered around the block for a time. Looking. Then finding. Then leaving.
This time with all alive and uninjured.

Then more of the story that sounds too familiar to me as a family physician
in eastern Omaha. Drugs, violated protective orders, warrants for arrest
yet still somehow released from jail, impaired males separated long before
but somehow not getting the message, women and their families trying to
move on, and widening ripples as generations above and below, friends,
business associates, neighbors, and innocent bystanders are impacted.

The policemen soon exhaust the available information and leave, in search
of yet another who has moved much closer to the top of a long list. And
perhaps a new one to add to the list as an accomplice.

With the support of family and friends, a young mom leaves with her child…
to an even more uncertain future. She left brave, but the tears will soon
flow. She may even see her doctor in the next few days or weeks for help,
like one of our patients whose house was just shot up 3 days ago. Perhaps
the recent increased frequency of her visits predicted the shooting. Just
as the frequency will increase after…

Too much information. Too much excitement.

I leave also, to a much safer location….for now.

This is more and more difficult to deal with. Tough to understand that
education, opportunity, health, and medical school admission are about
social class. Tougher to understand the legal help and security are also
about social class, until we begin to listen and hear. Then the eyes begin
to open too.

Lots of Pop Pop Pop, some very loud and near, others more distant and
quiet, but getting closer. Especially for those on the front lines caring
for people.

Robert C. Bowman, M.D.
[log in to unmask]

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